Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Department of Thoracic and Cardiovascular Surgery, Medical Faculty, University Hospital, RWTH Aachen University, Aachen, Germany.
J Cardiovasc Transl Res. 2023 Aug;16(4):842-851. doi: 10.1007/s12265-022-10349-3. Epub 2023 Jan 20.
When returning blood to the pulmonary artery (PA), the inflow jet interferes with local hemodynamics. We investigated the consequences for several connection scenarios using transient computational fluid dynamics simulations. The PA was derived from CT data. Three aspects were varied: graft flow rate, anastomosis location, and inflow jet path length from anastomosis site to impingement on the PA wall. Lateral anastomosis locations caused abnormal flow distribution between the left and right PA. The central location provided near-physiological distribution but induced higher wall shear stress (WSS). All effects were most pronounced at high graft flows. A central location is beneficial regarding flow distribution, but the resulting high WSS might promote detachment of local thromboembolisms or influence the autonomic nervous innervation. Lateral locations, depending on jet path length, result in lower WSS at the cost of an unfavorable flow distribution that could promote pulmonary vasculature changes. Case-specific decisions and further research are necessary.
当血液回流到肺动脉 (PA) 时，流入射流会干扰局部血液动力学。我们使用瞬态计算流体动力学模拟研究了几种连接情况的后果。PA 源自 CT 数据。三个方面有所变化：移植物流量、吻合位置和从吻合部位到冲击 PA 壁的流入射流路径长度。侧方吻合位置导致左、右 PA 之间的异常血流分布。中央位置提供接近生理的分布，但会引起更高的壁面剪切应力 (WSS)。所有影响在高移植物流量时最为明显。中央位置在血流分布方面是有益的，但由此产生的高壁面剪切应力可能会导致局部血栓脱落或影响自主神经支配。根据射流路径长度，侧方位置会导致较低的壁面剪切应力，但代价是不利的血流分布，这可能会促进肺血管变化。需要具体情况具体决策和进一步的研究。
